Resident physicians in Sudan face a variety of physical and psychological stressors. Nevertheless, the prevalence of burnout syndrome among this critical population remains unknown. The purpose of ...this study was to estimate the prevalence rate of burnout and its associated factors in a sample of resident physicians in Sudan.
A cross-sectional design was used to assess the burnout syndrome among resident physicians at the teaching hospitals of Wad-Medani in Gezira state, east-central Sudan. Three hundred resident physicians at the dermatology, general surgery, pediatrics, obstetrics and gynecology, psychiatry, ear, nose and throat (ENT), oncology, urology, and internal medicine departments, were approached and invited to participate in the study. The Arabic version of the Maslach Burnout Inventory was distributed to respondents from July to October 2021.
From the 300 resident physicians, 208 (69.3%) responded. The average age of the study population was 29.99 ± 3.01 years, with more than half were females (56.7%), single (59.6%), and with more than three years of residency experience (50.5%). In total, 86.1% met the criteria for burnout in at least one dimension and 13.9% in all three dimensions. On the dimension of emotional exhaustion (EE), 70.7% reported high levels of burnout. While, 44.2% reported high levels of depersonalization (DP), and 73.1% experienced a sense of decreased professional accomplishment (PA). There were significant differences in burnout, EE, and DP levels among different specialties, with the pediatrics-specialty trainees reported higher levels. Burnout syndrome was associated with the working hours per single duty; participants who reported working for more than 24 hours had experienced higher levels of burnout, EE, and DP.
Large-scale studies are required to assess the determinants of burnout syndrome among resident physicians in Sudan. In addition, Stakeholders should urgently implement effective remedies to protect the mental health of resident physicians.
Symbiotic plant-fungi interaction is a promising approach to alleviate salt stress in plants. Moreover, endophytic fungi are well known to promote the growth of various crop plants. Herein, seven ...fungal endophytes were screened for salt tolerance; the results revealed that Aspergillus ochraceus showed a great potentiality in terms of salt tolerance, up to 200 g L−1. The indole acetic acid (IAA) production antioxidant capacity and antifungal activity of A. ochraceus were evaluated, in vitro, under two levels of seawater stress, 15 and 30% (v/v; seawater/distilled water). The results illustrated that A. ochraceus could produce about 146 and 176 µg mL−1 IAA in 15 and 30% seawater, respectively. The yield of IAA by A. ochraceus at 30% seawater was significantly higher at all tryptophan concentrations, as compared with that at 15% seawater. Moreover, the antioxidant activity of ethyl acetate extract of A. ochraceus (1000 µg mL−1) at 15 and 30% seawater was 95.83 ± 1.25 and 98.33 ± 0.57%, respectively. Crude extracts of A. ochraceus obtained at 15 and 30% seawater exhibited significant antifungal activity against F. oxysporum, compared to distilled water. The irrigation of barley plants with seawater (15 and 30%) caused notable declines in most morphological indices, pigments, sugars, proteins, and yield characteristics, while increasing the contents of proline, malondialdehyde, and hydrogen peroxide and the activities of antioxidant enzymes. On the other hand, the application of A. ochraceus mitigated the harmful effects of seawater on the growth and physiology of barley plants. Therefore, this study suggests that the endophytic fungus A. ochraceus MT089958 could be applied as a strategy for mitigating the stress imposed by seawater irrigation in barley plants and, therefore, improving crop growth and productivity.
The development of new approaches for sustaining soil quality, leaf health, and maize productivity are imperative in light of water deficit and soil salinity. Plant growth-promoting rhizobacteria ...(PGPR) and silica nanoparticles (SiNP) are expected to improve soil chemistry leading to improved plant performance and productivity. In this field experiment, water deficit is imposed by three irrigation intervals—12 (I1), 15 (I2), and 18 (I3) days. Plants are also treated with foliar and soil applications (control, PGPR, SiNP, and PGPR + SiNP) to assess soil enzymatic activity, soil physicochemical properties, plant physiological traits, biochemical analysis, nutrient uptake, and productivity of maize (Zea mays L.) plants grown under salt-affected soil during the 2019 and 2020 seasons. With longer irrigation intervals, soil application of PGPR relieves the deleterious impacts of water shortage and improves yield-related traits and maize productivity. This is attributed to the improvement in soil enzymatic activity (dehydrogenase and alkaline phosphatase) and soil physicochemical characteristics, which enhances the plants’ health and growth under longer irrigation intervals (i.e., I2 and I3). Foliar spraying of SiNP shows an improvement in the physiological traits in maize plants grown under water shortage. This is mainly owing to the decline in oxidative stress by improving the enzymatic activity (CAT, SOD, and POD) and ion balance (K+/Na+), resulting in higher photosynthetic rate, relative water content, photosynthetic pigments, and stomatal conductance, alongside reduced proline content, electrolyte leakage, lipid peroxidase, and sodium content under salt-affected soil. The co-treatment of SiNP with PGPR confirms greater improvement in yield-related traits, maize productivity, as well as nutrient uptake (N, P, and K). Accordingly, their combination is a good strategy for relieving the detrimental impacts of water shortage and soil salinity on maize production.
Objective: Histotripsy is a focused ultrasound therapy that ablates tissue via the action of bubble clouds. It is under investigation to treat a number of ailments, including renal tumors. Ultrasound ...imaging is used to monitor histotripsy, though there remains a lack of definitive imaging metrics to confirm successful treatment outcomes. In this study, a convolutional neural network (CNN) was developed to segment ablation on ultrasound images. Methods: A transfer learning approach was used to replace classification layers of the residual network ResNet-18. Inputs to the classification layers were based on ultrasound images of ablated red blood cell phantoms. Digital photographs served as the ground truth. The efficacy of the CNN was compared to subtraction imaging, and manual segmentation of images by two board-certified radiologists. Results: The CNN had a similar performance to manual segmentation, though was improved relative to segmentation with subtraction imaging. Predictions of the network improved over the course of treatment, with the Dice similarity coefficient less than 20% for fewer than 500 applied pulses, but 85% for more than 750 applied pulses. The network was also applied to ultrasound images of ex vivo kidney exposed to histotripsy, which indicated a morphological shift in the treatment profile relative to the phantoms. These findings were consistent with histology that confirmed ablation of the targeted tissue. Conclusion: Overall, the CNN showed promise as a rapid means to assess outcomes of histotripsy and automate treatment. Significance: Data collected in this study indicate integration of CNN image segmentation to gauge outcomes for histotripsy ablation holds promise for automating treatment procedures.
Water scarcity is a major challenge to wheat productivity under changing climate conditions, especially in arid and semi-arid regions. During recent years, different agronomic, physiological and ...molecular approaches have been used to overcome the problems related to drought stress. Breeding approaches, including conventional and modern breeding, are among the most efficient options to overcome drought stress through the development of new varieties adapted to drought. Growing drought-tolerant wheat genotypes may be a sustainable option to boost wheat productivity under drought stress conditions. Therefore, the present study was conducted with the aim to screen different wheat genotypes based on stress tolerance levels. For this purpose, eleven commonly cultivated wheat genotypes (V1 = Akbar-2019, V2 = Ghazi-2019, V3 = Ujala-2016, V4 = Zincol-2016, V5 = Anaj-2017, V6 = Galaxy-2013, V7 = Pakistan-2013, V8 = Seher-2006, V9 = Lasani-2008, V10 = Faisalabad-2008 and V11 = Millat-2011) were grown in pots filled with soil under well-watered (WW, 70% of field capacity) and water stress (WS, 35% of field capacity) conditions. Treatments were arranged under a completely randomized design (CRD) with three replicates. Data on yield and yield-related traits (tillers/plant, spikelets/spike, grains/spike, 100 grain weight, seed and biological yield) and physio-biochemical (chlorophyll contents, relative water content, membrane stability index, leaf nitrogen, phosphorus, and potassium content) attributes were recorded in this experiment. Our results showed that drought stress significantly affected the morpho-physiological, and biochemical attributes in all tested wheat varieties. Among the genotypes, all traits were found to be significantly (p < 0.05) higher in wheat genotype Faisalabad-2008, including biological yield (9.50 g plant−1) and seed yield (3.39 g plant−1), which was also proven to be more drought tolerant than the other tested genotypes. The higher biological and grain yield of genotype Faisalabad-2008 was mainly attributed to greater numbers of tillers/plant and spikelets/spike compared to the other tested genotypes. The wheat genotype Galaxy-2013 had significantly lower biological (7.43 g plant−1) and seed yield (2.11 g plant−1) than all other tested genotypes, and was classified as a drought-sensitive genotype. For the genotypes, under drought stress, biological and grain yield decreased in the order V10 > V2 > V1 > V4 > V7 > V11 > V9 > V8 > V3 > V6. These results suggest that screening for drought-tolerant genotypes may be a more viable option to minimize drought-induced effects on wheat in drought-prone regions.
Colloidal quantum dots (CQDs) are promising candidates for infrared electroluminescent devices. To date, CQD-based light-emitting diodes (LEDs) have employed a CQD emission layer sandwiched between ...carrier transport layers built using organic materials and inorganic oxides. Herein, we report the infrared LEDs that use quantum-tuned materials for each of the hole-transporting, the electron-transporting, and the light-emitting layers. We successfully tailor the bandgap and band position of each CQD-based component to produce electroluminescent devices that exhibit emission that we tune from 1220 to 1622 nm. Devices emitting at 1350 nm achieve peak external quantum efficiency up to 1.6% with a low turn-on voltage of 1.2 V, surpassing previously reported all-inorganic CQD LEDs.
The Leishmania OligoC-TesT and NASBA-Oligochromatography (OC) were recently developed for simplified and standardised molecular detection of Leishmania parasites in clinical specimens. We here ...present the phase II evaluation of both tests for diagnosis of visceral leishmaniasis (VL), cutaneous leishmaniasis (CL) and post kala-azar dermal leishmaniasis (PKDL) in Sudan.
The diagnostic accuracy of the tests was evaluated on 90 confirmed and 90 suspected VL cases, 7 confirmed and 8 suspected CL cases, 2 confirmed PKDL cases and 50 healthy endemic controls from Gedarif state and Khartoum state in Sudan.
The OligoC-TesT as well as the NASBA-OC showed a sensitivity of 96.8% (95% CI: 83.8%-99.4%) on lymph node aspirates and of 96.2% (95% CI: 89.4%-98.7%) on blood from the confirmed VL cases. The sensitivity on bone marrow was 96.9% (95% CI: 89.3%-99.1%) and 95.3% (95% CI: 87.1%-98.4%) for the OligoC-TesT and NASBA-OC, respectively. All confirmed CL and PKDL cases were positive with both tests. On the suspected VL cases, we observed a positive OligoC-TesT and NASBA-OC result in 37.1% (95% CI: 23.2%-53.7%) and 34.3% (95% CI: 20.8%-50.9%) on lymph, in 72.7% (95% CI: 55.8%-84.9%) and 63.6% (95% CI: 46.6%-77.8%) on bone marrow and in 76.9% (95% CI: 49.7%-91.8%) and 69.2% (95% CI: 42.4%-87.3%) on blood. Seven out of 8 CL suspected cases were positive with both tests. The specificity on the healthy endemic controls was 90% (95% CI: 78.6%-95.7%) for the OligoC-TesT and 100% (95% CI: 92.9%-100.0%) for the NASBA-OC test.
Both tests showed high sensitivity on lymph, blood and tissue scrapings for diagnosis of VL, CL and PKDL in Sudan, but the specificity for clinical VL was significantly higher with NASBA-OC.
Water stress or soil salinity is considered the major environmental factor affecting plant growth. When both challenges are present, the soil becomes infertile, limiting plant productivity. In this ...work a field experiment was conducted during the summer 2019 and 2020 seasons to evaluate whether plant growth-promoting microbes (PGPMs) and nanoparticles (Si-ZnNPs) have the potential to maintain soybean growth, productivity, and seed quality under different watering intervals (every 11 (IW0), 15 (IW1) and 19 (IW2) days) in salt-affected soil. The most extended watering intervals (IW1 and IW2) caused significant increases in Na+ content, and oxidative damage indicators (malondialdehyde (MDA) and electrolyte leakage (EL%)), which led to significant reductions in soybean relative water content (RWC), stomatal conductance, leaf K+, photosynthetic pigments, soluble protein. Subsequently reduced the vegetative growth (root length, nodules dry weight, and total leaves area) and seeds yield. However, there was an enhancement in the antioxidants defense system (enzymatic and non-enzymatic antioxidant). The individual application of PGPMs or Si-ZnNPs significantly improved leaf K+ content, photosynthetic pigments, RWC, stomatal conductance, total soluble sugars (TSS), CAT, POD, SOD, number of pods plant−1, and seed yield through decreasing the leaf Na+ content, MDA, and EL%. The combined application of PGPMs and Si-ZnNPs minimized the adverse impact of water stress and soil salinity by maximizing the root length, heavier nodules dry weight, leaves area, TSS and the activity of antioxidant enzymes, which resulted in higher soybean growth and productivity, which suggests their use under harsh growing conditions.
Abstract
Molecular pathology services for colorectal cancer (CRC) in Sudan represent a significant unmet clinical need. In a retrospective cohort study involving 50 patients diagnosed with CRC at ...three major medical settings in Sudan, we aimed to outline the introduction of a molecular genetic service for CRC in Sudan, and to explore the CRC molecular features and their relationship to patient survival and clinicopathological characteristics. Mismatch repair (MMR) and BRAF (V600E) mutation status were determined by immunohistochemistry. A mismatch repair deficient (dMMR) subtype was demonstrated in 16% of cases, and a presumptive Lynch Syndrome (LS) diagnosis was made in up to 14% of patients. dMMR CRC in Sudan is characterized by younger age at diagnosis and a higher incidence of right-sided tumours. We report a high mortality in Sudanese CRC patients, which correlates with advanced disease stage, and MMR status. Routine MMR immunohistochemistry (with sequential BRAF mutation analysis) is a feasible CRC prognostic and predictive molecular biomarker, as well as a screening tool for LS in low-middle-income countries (LMICs).
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes respiratory disorders, with disease severity ranging from asymptomatic to critical manifestations. The current retrospective ...study compared the efficacies of different antiviral regimens used in patients suffering from severe COVID-19 disease from 19 January 2020 to December 2021 in a single center in Saudi Arabia. In total, 188 patients were enrolled in the current study, including 158 patients treated with different antiviral regimens, and 30 who did not receive any antiviral treatment. Different antiviral regimens, including favipiravir, remdesivir, oseltamivir, favipiravir/remdesivir, and favipiravir/oseltamivir were adopted. The effects of using different antivirals and antibiotics on the survival rate were evaluated, as well as the presence of comorbidities. Among all severely affected patients, 39/188 (20.7%) survived. Both age and comorbidities, including diabetes and hypertension, were significantly correlated with high case fatality following SARS-CoV-2 infection. Remdesivir alone and the combination of favipiravir and remdesivir increased the survival rate. Surprisingly, both imipenem and linezolid helped in the deterioration of disease outcome in the patients. A negative correlation was detected between increased mortality and the use of favipiravir and the use of either imipenem or linezolid. Among the compared antiviral regimens used in the treatment of severe COVID-19, remdesivir was found to be an effective antiviral that reduces COVID-19 case fatality. Antibiotic treatment using imipenem and/or linezolid should be carefully re-evaluated.
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